Provider Demographics
NPI:1518842657
Name:CARROLL, DREW (APC)
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:
Last Name:CARROLL
Suffix:
Gender:M
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 THURMAN CT
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:GA
Mailing Address - Zip Code:31064-4260
Mailing Address - Country:US
Mailing Address - Phone:404-907-5517
Mailing Address - Fax:
Practice Address - Street 1:40 THURMAN CT
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:GA
Practice Address - Zip Code:31064-4260
Practice Address - Country:US
Practice Address - Phone:404-907-5517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC010190101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor